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General Practice - Recovery Consolidated Guidance for Practices 2021

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General Practice - Recovery Consolidated Guidance for Practices 2021 General Practice - Recovery Consolidated Guidance for Practices 2021 Primary Care Team – Working Together Additional Guidance and Support Version 0.1 26 April 2021 1 Section 1 Introduction and the Patients Perspective 4 1.1 Introduction 1.2 The Patients Perspective – the findings of the Health and Social Care Alliance Scotland Section 2 Managing Health and Safety, Infection Control & PPE, Risk and Business Continuity. 6 Risk and Business Continuity 2.1 Health and Safety Responsibilities 2.2 Infection Control and Training 2.3 PPE 2.4 Public Health – Primary Care Guidance 2.5 Managing the Environment 2.6 Managing Risk 2.7 Business Continuity Planning Section 3 Managing Demand, Access and Care Navigation 14 3.1 Patient Access 3.2 Triage vs Screening 3.3 Practice Front Door - Open or Closed? 3.4 Care Navigation 3.5 Managing Prescriptions, Appointments, Serial Prescribing and Test Results to Reduce Footfall 3.6 Covid Assessment Centres (CACs) 3.7 Patient Registrations Section 4 Managing the Workforce and Staff Welfare 19 4.1 Managing the Workforce 4.2 Staff Welfare Section 5 Near Me 21 Section 6 Managing Public Messaging and Communication 22 6.1 National Messaging 6.2 Practice Messaging Section 7 Summary and Conclusion 25 2 Appendices Appendix A – ALLIANCE Primary Care Report Appendix B - Scottish Government Driver Diagram Appendix C – FAQs and Resources Appendix D – What is TURAS learn Appendix E – Example of Telephone, Video & Face to Face Appendix F – Engaging with the Team and Managing Change Appendix G – Pentlands Medical Practice Reflections 3 Section 1 Introduction and the Patients Perspective 1.1 Introduction In the past year general practice teams have risen to the challenge of dealing with the Covid-19 pandemic, adapting services to meet patient demand and developing innovative ways of working. This has required clear leadership, determination and flexibility. Re-mobilise, Recover, Re-design, published in May 2020, set out the Scottish Government’s plans to restart as many aspects of our NHS services as possible. It set out that restoring normal services should mean capitalising on the gains we have made in new ways of working, prioritisation and collaboration, with the roll-out of new techniques, technology and clinically safe but faster pathways to care for patients. We undoubtedly face significant challenges going forward. To step up to meet these challenges, we must look to the achievements and successes of those working in general practice during this challenging period and to celebrate areas of innovation and good practice to meet the needs of the public (patients) and practice teams. This document brings together (and signposts to) current guidance to ensure that good practice is shared, and questions answered so that the way forward becomes clearer and general practice is supported to continue to deliver the high level of care it has always provided, but in a different way. It has been designed as a “work in progress” in order to receive feedback from practices and to allow for further expansion in future versions (for example - long term condition management) as more examples of good practice are shared and questions answered. The contents are by no means prescriptive as there is recognition that practices across the country are managing different challenges with diverse patient populations in different ways so each practice will need different solutions, but we hope this document will give you and your team ideas and suggestions of things you may want to consider in your practice. This document will be supported by a series of webinars (MS Teams live events) provided by NHS Education Scotland (NES), Health Improvement Scotland (HIS) and Scottish Government working collaboratively. This document is not a substitution for any other form of Covid-19 guidance and one of the risks in operationalising guidance is that guidance is regularly changing. Therefore, it is strongly recommended that practices have their own operational plans in place which are reviewed and updated regularly following appropriate national guidance provided by Scottish Government and Public Health Scotland (PHS). Please submit your feedback, any further questions, and examples of further good practice to: [email protected]. If you require any additional advice or have future training requirements, then please let Charlotte know. 4 1.2 The Patients Perspective - the findings of ALLIANCE Scotland Recent work by the ALLIANCE, which reported on patients experience of accessing care during the pandemic , not only highlighted the many positive experiences patients had accessing care but also some less than positive examples were also cited by both patients and staff. Therefore, as we move forward, it will be important that we all engage and communicate with patients about what, how and why services are being delivered both at a national and local level. In addition the ALLIANCE have reviewed these findings specifically for Primary Care and these findings are attached in Appendix A. The Scottish Government has produced a “driver diagram” to support this work (Appendix B). The overarching aim of this work is: “People will always be able to access the health and care services that are right for them, at the right time, from the right place”, with outcomes seeking to improve the patient experience, reduce complaints and increase staff job satisfaction. The diagram highlights change ideas, building on areas that practices have been developing over the last ten years, namely the patient safety agenda, the continued need to avoid harm, ensuring an equitable, flexible service for patients, and for practices to continue to develop processes and systems which learn from improvements and share good practice. The overall intention is to support accessibility and continue to deliver high quality, person centred care that meets the needs of practice populations and practice teams. A number of organisations can provide support for practices to make these drivers a reality including: NES (in particular the Practice Manager and GPN networks), HIS and the work of the Practice Administrative Staff Collaborative (PASC), on-going patient engagement through the work of the ALLIANCE, NHS inform (NHS24), SGPC (BMA) and RCGP. In addition to this recovery plan, on-going work on the implementation of the 2018 GP Contract and the transformation of Primary Care will continue. Realistic Medicine and the Chief Medical Officers (CMO) annual reports provide some overall themes to support delivering person centred care and engaging with patients in a patient centred way including shared decision making. 5 Section 2 Managing Health and Safety, Infection Control & PPE, Risk and Business Continuity. 2.1 Health And Safety GPs, General Practice Nurses and other professionals need no reminder of their professional responsiblities in relation to their role as a clinician. But GP Partners as independent contractors (who are the employers of the staff) also have other responsiblities. These responsiblities have been in existance for many years but, given the nature of the pandemic, it is worth re-emphasising those responsiblities which relate specifically to Health and Safety. General practice, like any other business in the UK, is governed by the Health and Safety at Work Act 1974 (the Act) which places a duty on employers to ensure that their workplaces are safe. The Act requires all businesses and employers to: ▪ Appoint a responsible person ▪ Provide information and training to staff ▪ Provide insurance ▪ Provide facilities such as toilets ▪ Provide first aid ▪ Undertake risk assessments ▪ Provide a health and safety at work policy and to display the appropriate poster ▪ Report accidents and illnesses All of the above requirements of the Act should be very familiar to practices and practice managers and are expanded further in Health and Safety Made Simple. However, in relation to Covid-19 there are additional areas that practices (and any other business in Scotland) now have responsibility for, namely: ▪ Risk assessments specific to Covid-19 ▪ Social distancing ▪ Cleaning, hygiene and handwashing ▪ Ventilation and air conditioning ▪ Working from home ▪ Vulnerable workers Further information can be found below: Making your workplace COVID-secure during the coronavirus pandemic (hse.gov.uk) https://www.gov.scot/publications/coronavirus-covid-19-safer-work-places-statement/ Although the Covid-19 pandemic has not provided any prescriptive or mandatory training for clinical and other staff within a GP practice, business compliance with the Act mandates that all businesses must comply with the new Covid-19 measures as above and provide the necessary training and information to their staff. 6 2.2 Infection Control Infection Control Manual: Infection control measures for the Health Service in Scotland are written by ARHAI (Antimicrobial Resistance and Healthcare Associated Infections) colleagues who sit within National Services Scotland (NSS). Over the last year they have been responsbile for reviewing and updating the infection control guidance for both community (primary) and secondary care at a national level and providing advice to local Health Board health protection teams on matters relating to infection control. The Infection Control Manual, Section 7 pertains to community care settings (which covers GP and other Primary Care settings). This should not be confused with section 5 which covers the acute and secondary care settings. The Infection Control Manual has been in
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